Laboratory of Inflammation Biology, La Jolla Institute for Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Cardiovasc Res. 2021 Mar 21;117(4):1166-1177. doi: 10.1093/cvr/cvaa188.
During virally suppressed chronic HIV infection, persistent inflammation contributes to the development of cardiovascular disease (CVD), a major comorbidity in people living with HIV (LWH). Classical blood monocytes (CMs) remain activated during antiretroviral therapy and are a major source of pro-inflammatory and pro-thrombotic factors that contribute to atherosclerotic plaque development and instability.
Here, we identify transcriptomic changes in circulating CMs in peripheral blood mononuclear cell samples from participants of the Women's Interagency HIV Study, selected by HIV and subclinical CVD (sCVD) status. We flow-sorted CM from participants of the Women's Interagency HIV Study and deep-sequenced their mRNA (n = 92). CMs of HIV+ participants showed elevated interleukin (IL)-6, IL-1β, and IL-12β, overlapping with many transcripts identified in sCVD+ participants. In sCVD+ participants LWH, those reporting statin use showed reduced pro-inflammatory gene expression to a level comparable with healthy (HIV-sCVD-) participants. Statin non-users maintained an elevated inflammatory profile and increased cytokine production.
Statin therapy has been associated with a lower risk of cardiac events, such as myocardial infarction in the general population, but not in those LWH. Our data suggest that women LWH may benefit from statin therapy even in the absence of overt CVD.
在病毒抑制的慢性 HIV 感染中,持续的炎症会导致心血管疾病(CVD)的发生,这是 HIV 感染者(PLWH)的主要合并症。在抗逆转录病毒治疗期间,经典血液单核细胞(CMs)仍然处于激活状态,是促炎和促血栓形成因子的主要来源,这些因子会导致动脉粥样硬化斑块的发展和不稳定。
在这里,我们通过选择 HIV 和亚临床 CVD(sCVD)状态的妇女机构间 HIV 研究(Women's Interagency HIV Study)参与者的外周血单核细胞样本中的循环 CMs 来确定其转录组变化。我们从 Women's Interagency HIV Study 的参与者中流式分选 CMs,并对其 mRNA 进行深度测序(n=92)。HIV+ 参与者的 CMs 表现出升高的白细胞介素(IL)-6、IL-1β 和 IL-12β,与 sCVD+ 参与者中许多鉴定的转录本重叠。在 sCVD+ 参与者的 LWH 中,报告使用他汀类药物的参与者的促炎基因表达水平降低到与健康(HIV-sCVD-)参与者相当的水平。他汀类药物非使用者则保持升高的炎症特征和增加的细胞因子产生。
他汀类药物治疗与一般人群中心肌梗死等心脏事件的风险降低相关,但在 LWH 中并非如此。我们的数据表明,即使没有明显的 CVD,女性 LWH 可能从他汀类药物治疗中受益。